Oct 14 2011 1:00pm

A Plea to SFF Writers for Variety in Pregnancy and Childbirth Depictions

We all know how the basics of pregnancy and childbirth go in pop culture, including SFF. It’s usually an unplanned pregnancy. The pregnant character discovers the pregnancy after throwing up breakfast several days in a row, which may coincide with finding clothes tighter at the waist. As the pregnancy progresses, the character experiences turn-on-a-dime mood swings and cravings for unusual foods or food combinations.

Labor is preceded by the pregnant character going on a cleaning or decorating binge. It starts abruptly and unmistakably, usually with water breaking, and takes only a matter of hours. The character will be lying down in bed during labor and delivery, will scream a lot, and will gain unusual strength — which will be used to break the hand of any companion. If the forthcoming child’s father is present, the pregnant character will curse and berate him; regardless, any father will have freaked out at the very prospect of labor and is likely to be entirely useless.

And here’s the thing. It’s not that any of these things are wrong, that is, that they never happen. But they’re boring. Pregnancy and childbirth vary remarkably across people, and even across different pregnancies of the same person, and falling back on the same clichés over and over again is not only lazy, but likely to bore or irritate a substantial portion of readers (including me). Fortunately, it’s not very hard for SFF writers to do better.

The easiest thing any writer can do is, quite simply, to remember that there is a huge variety of experience out there. Lots of people — but not all of them — have pregnancy nausea in the first trimester. (I did, both pregnancies.) Some people — but not all of them — throw up, at any or all times of day. (I never did.) The same goes for mood swings, food cravings, food aversions, the nesting phase (cleaning/decorating before labor), and basically any other symptom. The very easiest thing for writers to do, then, is to take a cliché and vary the intensity.

Of course it’s better to do minimal research. For instance: yes, in the first trimester a pregnant person might find clothes fitting tighter around the waist (which is more likely to be bloating than uterine growth), but it’s my understanding and experience that, more often, clothes will start fitting tighter around the chest — I suspect people without close experience of pregnancy may not realize that increases in breast size start that early (and often hurt, too). Writers can pick up symptoms and side effects from reference books or websites and feel relatively confident that enough people have experienced them that the book or website thought them worth mentioning (or they can lampshade it if they’re really concerned: “Oh, yeah,” said pregnant character, “I’d never heard of that either, but my relative says this always happens in my biological family / my friend experienced something similar / whatever.”

Labor and delivery is an area where many writers could particularly profit by minimal research. If the character will be giving birth somewhere at or below the current tech level in the U.S., I recommend Pregnancy, Childbirth, and the Newborn by Peggy Simkin et al., which covers a range of interventions and procedures, from “resting in this position can encourage the fetus to shift to a more favorable position for delivery,” all the way through to “here is when an emergency C-section might be needed and what will happen.” But skimming any recent resource should explain, at minimum, that contractions do not equal labor and the reasons why it’s hardly universal for someone to spend all of labor lying down in bed.

Of course, SFF writers aren’t limited to current U.S. tech levels. Iain M. Banks’ Excession is set in the Culture, a society so advanced at bioengineering that people can self-induce sex changes. I re-read it when I was six months pregnant, and I was nearly as boggled that the Culture had pregnancies as I was by the choice of one of the characters to pause her pregnancy at nine months for forty years (forty years!). In contrast, Lois McMaster Bujold’s Vorkosigan universe is much less technologically advanced than the Culture, but it nevertheless has uterine replicators. In other words, before writing pregnancy and childbirth, SFF writers should ask themselves whether pregnancy (particularly unplanned pregnancies) and childbirth exist in their universe.

(As I write this, I am thirty-six weeks into my second pregnancy. I have had very easy pregnancies so far, fetal movement is kinda neat, there is a certain intimacy to the process, and I would use a uterine replicator in a heartbeat.)

If there are pregnancies in a SFF universe, there’s no reason that the side-effects, let alone delivery, have to be the same. A friend suggests interventions to forestall gestational diabetes or to avoid the “there’s not enough room in this abdomen for all of us” discomfort, plus adapting beaming tech for delivery. Right this minute, my life would be considerably improved by cheap in-home clothing fabricators, something to reduce swelling in my hands, a lower-gravity field around my bed, and a way to take medications without affecting FutureSibling. This is, of course, just the tip of the iceberg.

SFF writers should also consider the society’s general attitude toward reproduction, pregnancy, and childbirth. American society tends to consider visible pregnancy as a reason to lower social barriers, both conversationally and physically. (Never, ever, ever touch someone’s pregnant belly without permission. While you’re at it, don’t give unsolicited advice or tell horror stories, either.) Are pregnancies public property (figuratively or literally) in your SFF society, something intensely private, somewhere in-between? Are they generally approved of, disapproved of, considered a harmless quirk? Is childbirth scary and mysterious, unexceptional, the big event or a precursor to a more socially significant milestone? How tightly linked is reproduction to sex, both in the sense of how the gametes get together and in the sense of the identities of the parent(s)?

Finally, it’s outside the scope of this post, but I would be remiss if I didn’t point out that any particular pregnancy or childbirth has structural and thematic implications for the work it’s in, which often fall into their own predictable categories — such as SFF’s tendency to see pregnant bodies as horrific and tools/things to be invaded, the way infants tend to vanish after birth, and fairly narrow depictions of motherhood. But at minimum, SFF writers, please: vary your depictions of pregnancy and childbirth. This reader, at least, will thank you.

Kate Nepveu was born in South Korea and grew up in New England. She now lives in upstate New York where she is practicing law, raising a family, getting ready for FutureSibling’s arrival, and (in her copious free time) writing at Dreamwidth and her booklog.

Jed Hartman
1. elysdir
This is great--thanks for writing it! I noticed the nausea-means-pregnancy trope a while back, but I hadn't thought through the rest of this; great points.
Kate Nepveu
2. katenepveu

Note regarding comments: this is not the place to criticize other people's opinions regarding pregnancy and childbirth, though factual statements and anecdoctery are fine. (Also, as the post says, no unsolicited advice, no horror stories.)

Some anecdotery, free for writers to use if they like:

* Depending on a pregnant person's distribution of weight, fetal movement may be clearly visible late in pregnancy. FutureSibling likes to thrash when I eat raisins and chocolate and it's really easy to see. FutureSibling also often takes up more space on my right than my left, and that asymmetry is visually obvious to me, though I actually haven't asked anyone else if they can see it from the front.

* As of three years and a bit ago, fetal echocardiograms were able to determine which direction the blood in a fetus's heart was flowing by using the Doppler effect. Which is so cool, way cooler than watching valves open and shut, which I thought looked kinda freaky.

* An example of the variety of people's experiences: an acquaintance told me she liked to take really long walks as she neared delivery, as in two hours long. I think my eyes just about bugged out of my head at the thought of doing that myself.

* I have been having very noticable Braxton Hicks contractions for weeks now, and it is still weird to poke my belly during them and feel so much of it be so hard to the touch.

* And a link to the regular pictures we took during my first pregnancy and (much less often) this one.

(Also, thank you for the extremely awesome accompanying graphic!)
Kimani Rogers
3. KiManiak
Really interesting post. Thanks.

Just out of curiosity: Does the direction of the blood flow in the fetus's heart change often? Does the change reflect some stage of development or some other common occurrence? Or, is the change in direction of blood flow a bad thing (which would be my uninformed, layman's assumption) that happens often enough in developing fetuses to require constant monitoring?

Otherwise, I don't understand the use of monitoring via the Doppler effect evolving into a fetal echocardiogram. Are developing babies at some kind of major risk to have heart and circulation developmental issues to the point where this constantly must be monitored? Or is this a one-in-a-billion type possibility that doctors check in addition to the other one-in-a-million/billion developmental concerns?

Seriously; does the flow direction change often/as a common occurrence? Not that I'm freaking out about this (much). Just curious.
Kate Nepveu
4. katenepveu
Sorry, should've done some context. A test early in my pregnancy with SteelyKid suggested an increased risk of heart problems, among other things (first trimester screen; pregnant persons considering this should discuss the false positive rate with their health care providers), so we had a fetal echo somewhere around week 20-odd. As I understood it then, it wasn't monitoring the blood flow for changes while we were watching, because it wasn't that long a test; it was looking for defects or problems, including blood going the wrong way.

This pregnancy, we did a routine anatomical ultrasound around week 18 that showed all the bits in their proper places and so had no reason to do a special fetal echo; the regular ultrasound showed the valves opening & closing again but I don't _think_ checked the flow direction with Doppler.
EC Spurlock
5. EC Spurlock
Thanks for touching on a subject I hadn't consciously considered. Considering what a Good Ol' Boys Club sf was for so long (and still is in some respects) I'm not surprised that many writers go for stereotyped tropes, if they even think about it at all.

I never had nausea with either of my pregnancies and ony threw up once (and that due to food poisoning); but due to the effect of the change in circulatory patterns on my already chronically low blood pressure, I did have lots of dizzy spells and an occasional faint, which I understand is also common in the first trimester and a reliable indicator of pregnancy.

I was encouraged to walk a lot during pregnancy as it's supposed to limber the muscles and make delivery easier. I also spent a couple of hours walking around the hospital DURING labor to determine whether it was true or false labor and get things moving if it was for real.

I don't recall having actual cravings but because I was having my children later in life i was put on a very strict diet, cutting way back on processed foods, sugar and starches and boning up on foods that contained the optimum vitamins and nutrients for each month of development. (I suppose in an sf novel I would have been given a meticulously-calibrated daily pill.)

Attention should also be given to the baby's response to external media such as sound. I will never forget going to a Paul Winter concert in my 8th month and one of his musicians made a wierd keening sound with a bodhran that upset my son so much he turned into a rigid two-by-four sideways. Not comfortable in an auditorium seat.

Social aspects to consider would be whether the father is acknowledged or even considered relevant; whether/how many children is considered the norm/rule; and how an addition to the family affects both the internal and external social heirarchies. Also relevant is the origin of the species; I had a species that evolved from an aquatic mammal, and the mother spent the later stages of pregnancy, birth, and the early stages of nursing happily floating in a hot tub.

Woops, sorry for the text wall....
Kate Nepveu
6. katenepveu
Or whether there is a father at all! (Obviously there are families *now* in where there is no father in a social sense, but for SFF purposes, what about genetically?)

I gather that *hot* tubs are not recommended for human women, but that showers, tubs, and birthing pools are becoming more common labor & delivery presences. I definitely find it harder and harder to get myself *out* of the shower . . .
7. gdhansen
Kate, thanks for this post! I'm about 35 weeks into my second pregnancy, and have been amazed at how much it has differed from my first pregnancy, and how much both pregnancies have differed from the stereotypes. I also have happened to read a number of novels with pregnant characters during this pregnancy (not by design, just by coincidence) and found myself incredibly irritated by the sameness of all the pregnancy depictions.

I've also been struck by how much my experience of pregnancy is informed by science fiction (e.g. as we watch the baby move, my husband and I can't help thinking that it looks like an alien is about to burst from my stomach).
EC Spurlock
8. pnkrokhockeymom
Kate, thank you so much for writing this post!
EC Spurlock
9. DRK
Very interesting post. Another problem with all fictional pregnancies being the same is that no female character of child-bearing years can ever be inexplicably nauseated for any OTHER reason than pregnancy.
EC Spurlock
10. Evan D. Goer
Great post, Kate.

The water-breaking trope is *everywhere* -- it's hard to find a TV episode or movie involving labor that doesn't fall back on it. It's annoying, probably in the same way that getting things wrong about guns annoys gun people, or getting things wrong about horses annoys horse people.

There's also the trope that labor just "starts" suddenly at some moment, rather than being a slow, continuous process that is hard to chop up into neat little phases (even though we certainly do try!)

The biggest trope that I wish writers would rethink is: "If I make the space to include a childbirth scene, it must necessarily include an extremely dramatic technological intervention, injury, or death." Of course, I understand the temptation to do amp things up, this being fiction and all. But there's *plenty* of drama and story development to be found in childbirth beyond that particular narrow set of narrative tricks. (Note: this caution goes double for writers raised in the birthing culture of the United States and all that that entails.)
EC Spurlock
11. Evan D. Goer
I should clarify that the water-breaking trope isn't strictly speaking *wrong*. It's just that real-life labors typically don't proceed that way. So that trope is a kind of signpost that the writers are just copying other lazy writers, rather than doing their own homework.
Stephanie Leary
12. sleary
Great post. Thanks, Kate!

I'm with gdhansen: so far (32 weeks), my experience resembles the dinner scene in Alien more than anything meant to depict an actual pregnancy.
Kate Elliott
13. KateElliott
Kate, thanks for this lovely post.

Sadly, it seems like we were talking about these same things 20 years ago but (typically) not really being heard. On a panel once I suggested that in all the focus on war and battle, it was worth remembering that pregnancy, labor, and childbirth could also be "re-imagined" as (as in, looked at as if they were) dramatic situations. To which one of the (male) panelists replied, essentially, "but all labor and delivery is alike."

I also honestly think that even when pregnancy and childbirth is included as part of the fabric of a story, it is often overlooked in terms of its importance to the narrative and/or seen as a purely "woman's concern" (which means it can be overlooked).
Kate Nepveu
14. katenepveu
gdhansen @ #7, sleary @ #12: there were definitely points during some of the many ultrasounds we had with SteelyKid where we said, "Wait, that looks like a burst-out-of-stomach alien!" Also a Whitney Strieber alien, among other things, IIRC. Mostly my SFF fannishness comes through in being cranky about not having my flying car equivalent, but then I think I only saw _Aliens_ and that mostly through half-closed eyes, because horror movies and I do not get along. =>

Evan D. Goer @ #10, I understand that water-breaking is dramatic and everything, but again: cliche, therefore boring. (I will cut writers slack for generally ignoring the third stage of labor, i.e., after the baby comes out, because that's rarely going to be able to hold a candle to the emotional impact of what came immediately before.)

KateElliott @ 13, I certainly have no delusions of originality! It's just been on my mind lately for obvious reasons. I am of two minds though about pregnancy and childbirth being overlooked in a story, though, so perhaps some examples would be useful?

Me, I get tired of being treated as though my pregnancy is the only thing about me. Literally, I had someone ask me how I was feeling, and when I responded with a comment about some non-pregnancy ailment, said, "No, I meant with the pregnancy." Because I = my pregnancy. (Twice. They did this again *after* I said something the first time.) And on the social chatter front , the number of people who used to ask how I was and now ask how I'm feeling is really noticeable. This is vexing.

Also, from a genre standpoint, I could really use some works that take a pregnancy as *not* a plot focus point. _Stargate Atlantis_'s treatment of Teyla's pregnancy still pisses me off--they wrote in the actress's pregnancy by making the character pregnant, but instead of just, you know, hey, I'm pregnant, so I'll need some parental leave from missions around this time, they had to make it dramatic!!! . . . by turning her expected child into a biological weapon and her into a pawn to be rescued.

Which is a long way of saying that I would find it pretty refreshing if pregnancy and childbirth were treated just as part of life. (I tried to re-read Tanya Huff's _Sing the Four Quarters_, because I seemed to recall that the protagonist there is pregnant and mostly goes about her business all the same, but the opening was not promising from a physical-symptoms perspective and then I got distracted by something else.) On the other hand, if writers didn't go for sucky tropes, maybe I'd be less wary about the whole idea. So what do you have in mind?

Writers, a handy little worldbuilding detail: is there a small-talk default regarding pregnancy in your world, and if so, what is it?
Bernadette Durbin
15. dexlives
Shortly after my first pregnancy, I was reading a mystery that was part of a series in which the protagonist was in a committed relationship. I actually figured out she was pregnant from all of the subtler signs—the particular tiredness, certain weird pains, and no extreme nausea—before said character had a dramatic miscarriage.

Won't say which book, because it *is* a plot point, but I've re-read the book since and I don't see the pregnancy signs as clearly as I did when I was just out of them. It's very impressive to me that the writer basically wrote a real pregnancy for a physically active woman who thought she was infertile, so she never figured out her symptoms. As I would not have had I not just been through a similar experience (minus the miscarriage.)

Speaking of miscarriages—common, heartbreaking, and all but invisible in fiction unless they're plot points. Make that major plot points.
Kate Elliott
16. KateElliott
Kate, I'm thrilled you wrote this, just sad that after all this time the discussion still seems fresh and necessary.

As for examples, let me ask on my blog for examples from both readers and writers as that will sweep with a larger net (I get frustrated because I suspect that one of the things certain readers feel is "unecessary" in my fantasy is my writing aboutf things like this as opposed to all war and politics, and I suspect that's true for other writers as well. I know Katharine Kerr in her Deverry series dealt with post-partum depression in a society that had no word or diagnosis for it, for one example of a related situation.)

I also think caring for small children within the context of sff is not done as often (or as well) as it could be in a genre that thrives on stories wrapped around orphans and loners who have no "ties" to hold them down. Again, though, related but not quite the same.

And I totally understand about pregnancy==me issues. When I had a high risk pregnancy, everything got so focused on that I almost felt I ceased to exist.

Evan: amusingly, my actual labor (rather than Braxton Hicks) for my first child began with a dramatic water break.
Kate Elliott
17. KateElliott
dexlives #15: So true about miscarriages and / in sff fiction.
EC Spurlock
18. Rik Roots
This post made me reconsider how I represent pregnant characters in my writing. The sad conclusion is that, beyond maybe mentioning that the character is pregnant, I mostly avoid the issue. So thank you, Kate, for opening my eyes to new possibilities for writing my characters.

Of course I've blogged my thoughts on the matter ...
EC Spurlock
19. Evan D. Goer
KateElliot: Heh! Well, I guess that was your cue to start looking around for other signposts about which medium/genre you're living in. For example, was the OB or other labor support professional unusually zany? Then you're in a situation comedy.
EC Spurlock
20. JohnnyMac
A very interesting post.

A good example of the hazards of writing about pregnancy without firsthand experience is found Poul Anderson's introduction to his novel "The Man Who Counts" (one of his Van Rijn series). He wrote:

"I was saved from making one grievous error, by my wife. Looking over my proposed life cycle of the Diomedeans, she exclaimed, "Hey, wait, you have the females flying thousands of miles each year while they're the equivalent of seven months pregnant. It can't be done. I know." I deferred to the voice of experience and redesigned."
Anne Gray
21. Netmouse
Thanks so much for this post, Kate! Speaking as someone who just went through pregnancy and (cesarean) birth last year, I think our whole society would be better off if there was more depiction of people being pregnant and giving non-emergency non-crisis birth, as well as the period immediately after.
I had vague, constant nausea throughout my first trimester that was nicely taken care of by sucking on hard candy (keeping a little sugar in my stomach), but our first strong indication that I was pregnant was that I got a cold sore on my lip; having Herpes, I regularly dose with L-Lysine to prevent this, so it was strange. My husband, who's an imunologist, said, "Well, you could be pregnant. The immune system is depressed during the beginning of a pregnancy so your body doesn't reject the fetus."
At 9 weeks, I had appendicitis and an appendectomy, which we found out is in fact not uncommon - again, Brian's comment was that this could be a result of the immune system's ramping back up and dealing with bacteria that have accumulated while it was not functioning at speed. Not something I had ever thought about in detail before. Detection is of course complicated by the fact that ligament pains in the belly during pregnancy can be similar to appendicitis. My surgeon made the final call after strongly jostling my hospital bed - something that would have hurt the ligaments but didn't bother me at all. High tech, eh?

What I would also like to see more varied coverage of is breastfeeding. We had a doula and established breastfeeding shortly after we got to the recovery room with no problems, but I know so, so many women who faced a major struggle or were unable to breastfeed, and many of them were totally taken by surprize, because the standard media and literature picture doesn't include that at all - especially the struggle, such as in the US, between parents who want to do things one way and the institutions that will recommend interventions, often ones that may not be best for the baby or to support the interaction and communication between the baby, who brings the milk in by demanding it, and the mother's body, that responds to that physical signal. There are a number of technical support devices for this sort of thing and it would be *awesome* to see SF that explores possible improvements to those.
EC Spurlock
22. a1ay
Too long to quote, but the bit about how Modern Novelists address childbirth from "Cold Comfort Farm" comes to mind...

"Flora had learned the degraded art of 'tasting' unread books, and now, whenever her skimming eye lit on a phrase about heavy shapes, or sweat, or howls, or bedposts, she just put the book back on the shelf unread."
Rob Munnelly
23. RobMRobM
You guys have not mentioned perhaps the most disturbing pregnancy situation in relatively recent SFF - the pregnancy of Morn Hyland and birth of her child in Donaldson's The Gap Series. Circumstances of impregnation are horrifying; specifics of pregnancy/birthing process are horrifying (hint - alien technological advances!!!!!); and end result is physically and emotionally difficult for mother and child. I don't want to say more out of respect for spoilers but Morn is practically a walking TV Trope for being put through the plot wringer relative to sex and pregnacy. I'll reserve comment on what happens on the other side of the wringer.

Teresa Jusino
24. TeresaJusino
Here's an interesting video that talks about the trope that you touch upon in your final paragraph: The Mystical Pregnancy! :)

Great post, though, Kate. It's true! Women are different - fancy that!
Kerry Dustin
25. rocalisa
As someone who had a premature baby for no apparent reason at 27 weeks, that's also something to consider. Can your med tech deal with that. Is there no such thing as a prem baby because you can maintain a pregnancy better than we can? Can you stop or slow early labour? If not, what is the likely outcome for mother and baby?

I was also amazed to look back later and see that my body seemed to know what was coming as I had my only bit of craving (mashed potato) and nesting a couple of days before labour started. To this day (nearly 8 years later) we have no idea why labour started so early.

I agree we need depictions of pregnancy as something normal and not a huge drama, but you can have a not-normal pregnancy/delivery that still isn't a drama. We couldn't stop labour and delivery at 27 weeks, but all the services were there and we didn't actually have any huge dramas.
Kate Nepveu
26. katenepveu
Hi, everybody. I haven't gone into labor yet, I've just been really busy getting ready.

dexlives @ #15, yes, I definitely get the impression that the miscarriage rate is not well known--the "heavy period two weeks late" is a fairly common trope, maybe restricted to romances?, but that hardly captures the full range.

KateElliott @ #16, and IIRC there was what was clearly supposed to be PPD in one of Elizabeth Moon's Serrano books, though honestly I hadn't flagged it as such because of the other circumstances until one of the characters said something.

Rik Roots @ #18, glad to be of help!

JohnnyMac @ #20, goodness me, I had no idea that Karen Anderson was a winged creature . . .

Netmouse @ #21, yes, we had a fairly run-of-the-mill experience with nursing SteelyKid, but the time and energy commitment was rather a rude shock.

a1ay @ #22, that is brilliant.

RobMRobM @ #23, I had a weird fondness for the Gap series back in the day, which IIRC was high school/college, and I haven't dared revisit it because I really, really doubt it would hold up well for me now!

TeresaJusino @ #24, and yet I tried very hard to write this post as not applying just to women, as not only in SFF but today that's just not the case! (Though I failed with regard to one example, which vexes me.)

rocalisa @ #25, excellent point, and glad to hear there were no huge dramas.
Heidi Byrd
27. sweetlilflower
It always really bothers me when pregnant women are described as laying on their backs. Anytime I laid on my back, even the short amount of time it took for an ultrasound, I would have a lot of difficulty breathing. If I laid down and opened up my abdominal region, my son would immediately kick my lungs and ribs. It happens in TV shows and movies as well, and it always really bothers me.
Kate Nepveu
28. katenepveu
sweetlilflower, yes--I haven't been able to lie comfortably on my back for *months*.
Rob Munnelly
29. RobMRobM
@26 - I was shocked at how much I liked the Gap Series. Disturbing but brilliantly plotted and characterized.

By the way - good luck with the pregnancy and birth!

EC Spurlock
30. s'rEDIT
My thanks to Kate for remembering how to "lie" ;)
Lucy Sheppard
32. sphyg
I'd love to see more stories of people struggling with fertility problems in SFF.
Kate Nepveu
33. katenepveu
sphyg, another underrepresented area, unquestionably. Thanks for pointing it out.

(Not still pregnant.)
EC Spurlock
35. stupidgirl45
Um, also, why is that women are usually the pregnant ones. Why not men. or transgender?

Other than that - great article. I'm 26 weeks pregnant and we went to see prometheus last week and baby45 kicked all the way through which made me giggle. I did however, just double check with my husband that we had seen a baby on the scan, not an alien.

I think that the media in general misrepresent pregnancy/labour - it's so stereotyped, so SFF should be able to lead the way in incorporating more realism OR daring to do things differently.

I've had so many symptoms it's boring - so I want to see something different from my experience!
Kate Nepveu
36. katenepveu
Thank you--I had that in mind and tried to write inclusively (though not fully successfully) but didn't actually say it, which was unfortunate.

And hee, yes, I also saw a claw-out-of-stomach alien on one of my ultrasounds. Best wishes!

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